Provider Demographics
NPI:1497926836
Name:DEACON, JANE (NNP)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:
Last Name:DEACON
Suffix:
Gender:F
Credentials:NNP
Other - Prefix:
Other - First Name:JANE
Other - Middle Name:
Other - Last Name:DEACON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NNP
Mailing Address - Street 1:11712 E ADRIATIC PL
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-1164
Mailing Address - Country:US
Mailing Address - Phone:303-337-4950
Mailing Address - Fax:
Practice Address - Street 1:13123 E 16TH AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-7106
Practice Address - Country:US
Practice Address - Phone:720-777-6857
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-13
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO55706363LN0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care